Affiliations: Pathology and Laboratory Medicine, University of
Western Australia, Australia | Centre for Virology, Burnet Institute, Melbourne,
Australia | Infectious Diseases Unit, Alfred Hospital, Melbourne,
Australia | Department of Medicine, Monash University, Melbourne,
Australia | Centre of Excellence for Research in AIDS (CERiA),
Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia | University Malaya Medical Centre, Kuala Lumpur,
Malaysia
Note: [] Address for correspondence: Professor Patricia Price, School of
Pathology and Laboratory Medicine, University of Western Australia, Nedlands,
6009, Australia. Tel.: +61 618 9224 0378; Fax: +61 618 9224 0204; E-mail:
[email protected]
Abstract: Objectives: Chemokines influence the migration of leukocytes to
secondary lymphoid tissue and sites of inflammation. In HIV patients, they are
implicated in inflammatory complications of antiretroviral therapy (ART),
notably Immune Reconstitution Disease (IRD) and Sensory Neuropathy (SN).
However most chemokines have not been monitored as patients begin ART or
correlated with IRD and SN. Methods: Plasma chemokine levels were
assessed longitudinally using commercial ELISAs in 69 patients treated in Kuala
Lumpur, Malaysia. Plasma was available at baseline and after 6, 12, 24 and 48
weeks on ART. Chemokine genotypes were assessed using allele-specific
fluorescent probes. IRD were diagnosed in 15 patients. 30 patients were
screened for SN using the ACTG BPNS tool after six months on ART. SN was
detected in 8 patients. Results: Plasma CXCL10 levels decreased on ART
compared to baseline (p=0.002–0.0001), but remain higher than healthy
controls (p� 0.0001). The decline was clearer in patients without IRD.
CCL5 levels rose on ART but remained similar to controls. CCL2 levels were
higher in patients than controls after week 12. Plasma chemokine levels were
not affected by CD4+ T-cell counts or any genotypes tested. Several patients
with SN displayed higher CCL5 levels throughout therapy compared to patients
without neuropathy. Levels of other chemokines and chemokine genotypes were not
associated with SN. Conclusions: Chemokines are differentially affected
by ART. CXCL10 and CCL5 may influence IRD and CCL5 warrants further
investigation for an effect in SN. These trends are not influenced by chemokine
genotypes investigated here.
